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首页> 外文期刊>Кардиология >Effects of long term therapy with angiotensin converting enzyme inhibitor quinapril, antagonist of receptors to angiotensin II valsartan, and combination of quinapril and valsartan in patients with moderate chronic heart failure. Main results of the
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Effects of long term therapy with angiotensin converting enzyme inhibitor quinapril, antagonist of receptors to angiotensin II valsartan, and combination of quinapril and valsartan in patients with moderate chronic heart failure. Main results of the

机译：血管紧张素转换酶抑制剂奎那普利，血管紧张素II缬沙坦的受体拮抗剂以及奎那普利和缬沙坦的组合对中度慢性心力衰竭患者的长期治疗效果。主要结果

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AIM: To compare effects of therapy with angiotensin converting enzyme inhibitor quinapril (Q), angiotensin II receptor antagonist valsartan (V), and their combination in patients with stable moderate chronic heart failure (CHF). MATERIAL AND METHODS: Patients (n=80) with NYHA class II-III CHF due to ischemic heart disease, dilated cardiomyopathy or decompensated hypertensive heart and ejection fraction <40% were randomized into 3 groups. Patients of group Q, V and Q+V received Q (average dose 13 mg/day, n=28), V (121 mg/day, n=26), and combination of Q and V (12 and 78 mg/day, n=26), respectively. Methods included assessment of clinical state and quality of life, echocardiography, 6 min walk test, Holter ECG monitoring with measurements of parameters of heart rate variability (HRV), and determination of neurohormones in peripheral blood. Examinations and measurements were made at baseline, in 3 and 6 months. RESULTS AND CONCLUSIONS: Six months therapy with Q, V and their combination resulted in improvement of clinical and functional state of patients. More pronounced augmentation of exercise tolerance and lowering of CHF functional class were observed in group Q. Combined use of Q and V had no significant advantages over monotherapy with Q and V when effect on parameters of left ventricular remodeling were concerned. Therapy with Q was associated with "escape" of blockade of aldosterone synthesis and "reactivation" of angiotensin II formation after 6 months. The use of V and combination of V+Q allowed to achieve more stable but incomplete control of aldosterone activity. The use of Q appears to be the preferential regimen to influence activity of sympathoadrenal system and parameters of 24 hour HRV compared with V and Q+V. Long term therapy with V does not improve main parameters of 24 hour HRV.
机译：目的：比较血管紧张素转化酶抑制剂奎那普利（Q），血管紧张素II受体拮抗剂缬沙坦（V）及其组合对稳定的中度慢性心力衰竭（CHF）患者的治疗效果。材料与方法：将80例因缺血性心脏病，扩张型心肌病或失代偿性高血压，射血分数<40％引起的NYHA II-III型CHF患者随机分为3组。 Q，V和Q + V组的患者接受Q（平均剂量13 mg /天，n = 28），V（121 mg /天，n = 26）以及Q和V的组合（12和78 mg /天） ，n = 26）。方法包括评估临床状态和生活质量，超声心动图，6分钟步行测试，动态心电图监测和心率变异性（HRV）参数的测量以及外周血中神经激素的测定。在基线，3个月和6个月内进行检查和测量。结果与结论：Q，V及其组合治疗六个月可改善患者的临床和功能状态。 Q组观察到运动耐力的增加更加明显，CHF功能类别降低。当考虑到对左心室重构参数的影响时，Q和V的联合使用与Q和V的单药治疗相比没有显着优势。 Q的治疗与6个月后醛固酮合成的“逃逸”和血管紧张素II形成的“重新激活”有关。使用V和V + Q的组合可以实现对醛固酮活性的更稳定但不完全的控制。与V和Q + V相比，使用Q似乎是影响交感肾上腺系统活动和24小时HRV参数的首选方案。用V长期治疗不能改善24小时HRV的主要参数。

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